Unknown Individual – Obstetrics & Gynecology Physician, NPI 1609857911
Obstetrics & Gynecology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1900, Centracare Circle, Shady Oak Mobile Park, St. Cloud, Stearns County, Minnesota, 56303, United States
ST CLOUD, MN 56303
Phone: (320) 654-3630
Fax: (320) 654-3657
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56303)
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